My Father Didn’t Have Covid-19, but He Almost Died Because of It
By Ronen Bergman, New York Times, April 11, 2020
HAIFA, Israel — The E.R. doctor gave me an accusing look: “Clearly the deterioration did not begin today. Why did you bring him in only now? Without medical care, he would not have lasted the night.”
It was close to midnight on March 24, at Rambam Hospital in Haifa, the biggest hospital in the biggest town in the north of Israel. I was standing anxiously at the bedside of my 85-year-old father, Shmuel Bergman, who was unconscious. His partner was also by the bed. Blood tests had revealed a very high number of white blood cells, indicating a severe infection, and he was running a high fever. Doctors and nurses were urgently trying to identify the causes of his condition and to stabilize him.
The physician asking why we hadn’t brought Dad in earlier seemed to be implying that we were neglecting to take proper care of an elderly invalid who could not care for himself. I didn’t respond. Gazing sadly at my father, listening to the beeping of the monitors, I asked myself why we had brought him in so late. Our tardiness almost cost his life. Were we negligent?
I am the youngest child of parents who survived the Holocaust. It had one positive effect on the way my two older sisters and I grew up: total uncompromising commitment to our family.
My mother got cancer when I was a little boy and I grew up in the shadow of the disease. She died when I was 20.
Eleven years ago, my father got prostate cancer, and a year later, Alzheimer’s. Once again, the family was hit by a terrible, incurable affliction.
Since then we — my father’s partner, my sisters and their families — have become devoted to taking care of him on a daily, even hourly, basis. The concept, based on much research and some trial and error, was that Dad would not be moved to a nursing home and would stay in his own apartment, and we would set up a supportive, caregiving cocoon around him. The best physicians we could find, regular exercises indoors and out, physical and occupational therapists, taking him on family vacations. All this despite the fact that it was clear to us that none of it would cure what medicine cannot, but out of the hope that we could slow his decline.
It is not easy. At time it has required overcoming Dad’s objections. And he has always been opinionated and stubborn. Whenever one of the trainers appeared, he’d refuse to cooperate, claiming he wasn’t feeling well. Sometimes the only thing I could do was threaten him over the phone, saying I would leave whatever “very important work meeting” I was in to drive over to his place and make sure he did his exercises.
But on the whole, our approach to his care has worked.
For the past decade we have kept Dad with his head above water and in a reasonable physical and cognitive state. He turned 85 early last month. Yes, he has sadly declined, but it has been much slower than normally expected for someone in his condition.
And then came the coronavirus outbreak.
Stringent instructions were issued, along with dire warnings meant to protect older people, who are most vulnerable to the virus. “Elderly persons must absolutely avoid leaving home or receiving guests,” the Health Ministry admonished. Minister of Defense Naftali Bennet declared: “The most important rule is to protect grandfather and grandmother. Find creative ways of hugging and loving them, from a distance!” A public-service announcement on the military radio station said: “Save Grandpa and Grandma. Don’t go to visit them.”
My family was divided. Most of us thought that Dad and his live-in partner should be totally isolated in their home. This led to a series of discussions, sometimes arguments, within the family. All of us had only Dad’s well-being in mind, but there were disagreements over the right way to ensure it.
The first people who had to stop coming to Dad’s house were the trainers and therapists, the ones whose daily contact with him had kept him alert and active. Attempts to continue his sessions over video chats didn’t work.
Then most of us thought we, too, should stop visiting him. The health authorities were already predicting that within days, hundreds of Israelis would be on respirators, most of them old people, and their number would soon be in the thousands, with only 1,500 such machines available. (Those predictions proved wrong.) One family member made a grim prediction about what would happen if Dad were infected with the virus: “It is reasonable to assume that he would have very low priority when they have to decide who to respirate and who dies.”
After three weeks, I persuaded the family to allow me a visit. I immediately saw that something was seriously wrong. Dad was drifting away, disconnecting from his surroundings. Should we call a doctor? Just letting a doctor in risked infection, and there was going to be a shortage of respirators. We called one anyway.
The doctor advised us to go immediately to the emergency room. My sisters, Dad’s partner and I had more arguments, with some saying that hospitals were the worst place to be. We called another doctor, who said the hospital seemed too dangerous. A third doctor told us to call her again in a couple of days.
Over the next few hours I watched Dad slipping away from us. That morning he had responded to questions in a weak voice, but at around 4 p.m. he was hardly opening his eyes, and at 6 not at all. He had become totally detached. His temperature was going up. I felt I was being ripped apart. What do I know? What do I understand about medicine? Perhaps his decline was only temporary, maybe he was having a bad day, as he’d had in the past. Or was it a worsening of his Alzheimer’s or a spread of the cancer? Under any other circumstances, we would have taken him to the E.R. immediately. But if he contracted the coronavirus at the hospital and died as a result, would I be able to look his partner and my sisters in the eye?
The rumors about Israel’s hospitals were ominous: There was no more room. The medical staff was exhausted. There was no point in going, we had heard, because the E.R.s were overwhelmed with patients, and no one would pay attention to us. No one would waste time doing a CT scan on a sick 85-year-old.
Because of all this, someone suggested we take Dad to a nearby emergency clinic. It was difficult to lift him — he was no longer reacting — from his chair into a wheelchair and then into my car. I had promised my sisters I would not touch him, for fear of contagion, but there was no alternative.
The doctor at the clinic took one look at him and from behind his mask said: “I don’t know why you came here. He needs to go to the hospital E.R. urgently.” I drove like a madman to Rambam.
The rumors were wrong. The regular E.R. — not the isolated one opened for Covid-19 patients — was almost totally empty. People had stopped going there. There were more doctors and nurses with nothing to do than there were sick people. Dad was immediately admitted, and he received treatment that was fast, efficient and outstanding.
It turned out that we had gotten there at the last possible moment. Dad was suffering from severe inflammation of the urinary tract, which if left untreated could have led to an extreme decline in his condition or worse within a short time.
Four days later, he had recovered from the infection and we took him home. The antibiotics he was prescribed have caused side effects, and the inflammation is still bothering him, but we hope that his condition will stabilize soon.
Dad’s oncologist told me later that what had happened to us was not unusual. People suffering from heart trouble or other problems, or their families, were so afraid of picking up the coronavirus at the hospital that they did not go to get essential medical treatment, and when they did get to the E.R. it was often too late.
My dad has two very serious illnesses, and there are many more like him. The coronavirus crisis greatly exacerbates the difficulties and deliberations when caring for the elderly and other people at risk. Everyone wants only the best for them, but it is very difficult to know what that is.
I’m a reporter, not a doctor. I can’t give health advice. But I worry about how this new danger — at the top of the headlines and the tops of our minds — could affect people’s judgments. What I can say for certain is that I am glad I took my father to the hospital.
Published in the New York Times, April 11, 2020
Ronen Bergman is a staff writer for The New York Times Magazine, based in Tel Aviv. His latest book is “Rise and Kill First: The Secret History of Israel’s Targeted Assassinations,” published by Random House.